BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RASCAL

    MDR report key: 509237 · Received February 3, 2004

    Report

    Report Number
    2246975-2004-00007
    Event Type
    Injury
    Date Received
    February 3, 2004
    Date of Event
    January 3, 2004
    Report Date
    January 5, 2004
    Manufacturer
    ELECTRIC MOBILITY CORP.
    Product Code
    ITI
    Removal / Correction Number
    2246975.2002.002.C
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    DESCRIBE EVENT OR PROBLEM: WHEEL HUB CRACKED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RASCAL VEHICLE, 4-WHEEL MOTORIZED ITI ELECTRIC MOBILITY CORP. 305 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 58 YR Required Intervention